Active NPI
Port St. Lucie FL Opco LLC
- Skilled Nursing Facility
- Port St Lucie, FL
National Provider Identifier
1649974387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- PORT ST. LUCIE FL OPCO LLC
- Practice address
- 1655 SE Walton Rd
Port St Lucie, FL 34952-7657 - Phone
- (772) 337-1333
- NPI assigned
- Mar 28, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Batya Gorelick
- Title
- Manager
- Phone
- (201) 928-7808
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
1655 SE Walton Rd
Port St Lucie, FL 34952-7657
Mailing address
1655 SE Walton Rd
Port St Lucie, FL 34952-7657
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240403001924 | FL | Part A Provider - Skilled Nursing Facility | 8022456540 | Practice locations: Port St Lucie, FL |
Skilled nursing facility certification: CCN 105579
- Legal name
- PORT ST LUCIE FL OPCO LLC
- Doing business as
- SAVANNAS PARK HEALTH AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 1, 1987
- Last certification
- May 1, 2024
- Beds
- 120
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- LILAC HEALTHCARE GROUP
- Organization structure
- LLC
- Enrollment address
- 1655 SE Walton Rd
Port St Lucie, FL 34952-7657 - Nursing home name
- SAVANNAS PARK HEALTH AND REHABILITATION CENTER
- Affiliated entity
- ROBERT SCHOENFELD
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Savannas Park Health and Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Nov 1, 1987
- Medicare certification status
- Active
- Certified beds
- 120
- Chain
- Robert Schoenfeld
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0861355 | Port St Lucie FL Opco LLC | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryNetworks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| FL HC Opco LLC | 5% Or Greater Indirect Ownership Interest | Aug 11, 2023 | 100% |
| Robert B Schoenfeld | 5% Or Greater Indirect Ownership Interest | Aug 11, 2023 | 75% |
| Corporate Officer | Aug 11, 2023 | ||
| Sharon Schoenfeld | 5% Or Greater Indirect Ownership Interest | Aug 11, 2023 | 25% |
| Port St Lucie Holdco LLC | 5% Or Greater Direct Ownership Interest | Aug 11, 2023 | 100% |
Facilities with the same owner 4
Facilities that share an organizational owner with 5% or greater ownership or operational control.
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Port Saint Lucie, FL
- NPI 1568436103
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679961600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1679961600000",
"number": "1649974387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1655 SE WALTON RD",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349527657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1655 SE WALTON RD",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349527657",
"telephone_number": "772-337-1333"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PORT ST. LUCIE FL OPCO LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-03-28",
"last_updated": "2023-03-28",
"certification_date": "2023-03-28",
"status": "A",
"authorized_official_last_name": "GORELICK",
"authorized_official_first_name": "BATYA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "201-928-7808"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.